Dranitsaris et al developed a model for predicting chemotherapy-induced anemia in women with breast cancer. The authors are from Toronto Sunnybrook Regional Cancer Centre, London Regional Cancer Centre and Ortho-Biotech Inc in Ontario, Canada.
Parameters:
(1) hemoglobin before chemotherapy in g/L
(2) number of chemotherapy cycles received
(3) age in years
(4) platelet count
(5) prophylactic antibiotics
(6) adjuvant chemotherapy
|
Parameter
|
Finding
|
Points
|
|
number of chemotherapy cycles received
|
none
|
0
|
|
|
>= 1
|
-1
|
|
age in years
|
< 65
|
0
|
|
|
>= 65
|
2
|
|
platelet count
|
> 200,000 per µL
|
0
|
|
|
<= 200,000 per µL
|
1
|
|
prophylactic antibiotics
|
none
|
0
|
|
|
present
|
-1
|
|
adjuvant chemotherapy
|
CEF or CAF
|
2
|
|
|
FEC, FAC, FEC100, AC-T
|
1
|
|
|
CMF, AC or MF
|
0
|
where (see second column, page 857):
• CEF = cyclophosphamide, epirubicin, fluorouracil
• CAF = cyclophosphamide, doxorubicin, fluorouracil
• CMF = cyclophosphamide, methotrexate, fluorouracil
• FEC = fluorouracil, epirubicin, cyclophosphamide
• FAC = fluorouracil, doxorubicin, cyclophosphamide
• FEC100 = fluorouracil, epirubicin (at 100 mg per sq m), cyclophosphamide
• AC-T = doxorubicin, cyclophosphamide, paclitaxel
• AC = doxorubicin, cyclophosphamide
• MF = methotrexate, fluorouracil
risk score =
= (points for chemotherapy) + (points for age) + (points for platelet count) + (points for prophylactic antibiotics) + (points for adjuvant chemotherapy) - (0.25 * (hemoglobin before chemotherapy)) + 50
Interpretation:
• The higher the score the greater the risk of anemia.
• The logistic regression curve in Figure page 861 indicates a probability of 50% with a score of 25.1.
|
Risk Score
|
Incidence of Anemia
|
|
< 21
|
< 1%
|
|
21 to 22.9
|
3%
|
|
23 to 23.9
|
21%
|
|
24 to 24.9
|
40%
|
|
25 to 25.9
|
63%
|
|
26 to 26.9
|
83%
|
|
>= 27
|
85%
|
